Getting Out Alive and Staying That Way: Surviving your hospital or rehabilitation stay
If you happen to require impatient hospital or rehabilitation (rehab centers are commonly called Supervised Nursing Facilities, or SNFs) treatment here are a few tips that may help you get everything you need when you are released:
Hospital Discharge Planning is the process you go through to get ready to leave the hospital. The process may be long or short, depending on why you are in the hospital and how your needs may have changed as a result of your hospitalization.
Discharge planning needs to begin on the first day of your hospitalization. Hospitals have staff people who can help you make plans; they may be called discharge planners, case managers or social workers, depending on the facility.
Your hospital doctor (not necessarily your primary care doctor in the community) is the leader of the hospital healthcare team. All decisions regarding your treatment/discharge need to be authorized by the hospital doctor. Remember that you have a right to actually speak to your doctor in person and have her or him address your concerns.
<>p>If you can, involve family or friends in making decisions and arrangements.
Things You May Need Help With:
- Housing
- Activities
- Stairs
- Medication
- Errands
- Transportation
- Food
- Personal and home nursing care
- Household chores
- Equipment
- Physical therapy
- Follow-up appointments
Remember that hospital workers (including doctors) often have extremely high caseloads, so if you can, put your concerns in writing and be sure to give copies to the nurses, doctor, and discharge planner. Some hospitals have special carbon copy communication forms especially for this purpose. Keep a copy for yourself. In busy hospitals, “the squeaky wheel gets the grease,” so don’t be afraid to ask for and even demand what you are entitled to:
- A discharge instruction sheet should be given to you at the time of your discharge from the hospital. Make sure it has the addresses and phone numbers of doctors, as well as the dates and times of your follow-up appointments. Also, your medication dosages may have changed since your hospital stay: Follow the directions on your discharge instruction sheet as these are the most recent. These instructions may be different from what is listed on the bottles. This is very important.
- If you have questions or concerns about your discharge tell your doctor, or discharge planner/social worker/case manager as soon as possible.
- If you’re sent somewhere other than your home when you leave the hospital, tell the important people in your life so that they can reach you.
If your needs are not being met and you want to appeal your discharge (remember: you have a legal right to appeal), you will need to follow the procedures set by the type of insurance (including Medi-Cal) that you have. Additionally, each hospital has a patient advocate who can investigate any complaints you have about the hospital or your discharge. Ask someone at your hospital about contacting its patient advocate.
Community Services You May Qualify For:
- Aging and Adult Services Information and Referral: 1.800.510.2020
- In-Home Supportive Services: 415.557.5251
- IHSS Public Authority (on-call care/private pay): 415.243.4477
- Elder Care at Home (emergency home care): 415.982.9171 x. 144
- San Francisco Paratransit: 415.351.7000
- MV Transportation (lift vans): 415.468.4300
- Home Delivered Meals: 415.648.5592
- Friendship Line for the Elderly: 415.752.3778
- Retired Senior Volunteer Program Tele/Friend Program: 415.731.3335
To Appeal Your Discharge:
If you have Medicare:
- Insist on a written notice. It needs to be given to you 48 hours before your last coverage day.
- Call Lumetra (formerly CMRI), California’s Medicare quality improvement organization: 1.800.841.1602.
- Call HICAP (Health Insurance Counseling and Advocacy Program): 1.800.434.0222.
- You may have the right to an expedited appeal. Be sure to ask about this.
- For more information call 1.800.MEDICARE (1.800.633.4227) or visit http://www.medicare.gov
- If you have Medi-Cal, but not Medicare, call Bay Area Legal Aid: 415.982.1300.
- For automated information, call the California Department of Social Services: 1.800.952.5253.
Good luck in you recovery, and remember, you always have the right to refuse to leave the hospital if you feel that you are in need of further medical treatment.
If you are interested in working with others to make discharge planning better for seniors and people with disabilities in San Francisco, join the Healthcare Action Team—part of the organization Planning for Elders in the Central City. For more information or help with resources please call James Chionsini at 415.703.0188.
James
